Detection of Late Presentation of Poststernotomy Mediastinitis in an Infant by Positron Emission Tomography

(Department of Pediatric Cardiovascular Surgery and Department of Cardiovascular Surgery*, Southern Tohoku General Hospital and Southern Tohoku Research Institute for Neuroscience, Koriyama, Japan)

Shigehiro Morishima Takashi Ono Masatomo Honda
Megumu Kanno* Hirofumi Midorikawa* Kazunori Ishikawa*
Positron emission tomography (PET) is an established imaging tool in oncology that has also been used in infectious and inflammatory diseases. PET combined with computed tomography (PET/CT) can be used to visualize metabolic activity with precise localization. We report an infant with late presentation of poststernotomy mediastinitis, the diagnosis and localization of which was confirmed by PET/CT. An 8-month old infant, who had undergone the Jatene procedure and right ventricle outflow reconstruction 6 months prior, was admitted for inflammation surrounding the superior aspect of the healed scar. Cultures from the wound grew methicillin-resistant Staphylococcus aureus (MRSA). Although the only symptom was discharge from the wound, and there were no other signs or symptoms suggestive of severe general infection, substernal abscess was suspected by magnetic resonance imaging. Since PET/CT revealed high accumulation of 18-fluorodeoxyglucose at the substernal region, the diagnosis of MRSA mediastinitis was made, which was confirmed by subsequent surgical treatment.
@Jpn. J. Cardiovasc. Surg. 37: 96-99 (2008)